SUSAN WISKOWSKI (NPI# 1881616795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881616795 |
| Entity Type | Individual |
| Full Name | SUSAN WISKOWSKI |
| Credential | MD |
| Practice Address |
675 Tower Ave Hartford CT 06112-1260 |
| Practice Telephone | 8607142913 |
| Practice Fax Number | 8607148988 |
| Mailing Telephone | 8607142913 |
| Mailing Fax Number | 8607148988 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 027125 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BLUE SHIELD | 010027125CT01 | 01 |
| HEALTHNET | 0V4805 | 01 |
| Street Address |
675 TOWER AVE |
| City | HARTFORD |
| State | CT |
| Zip Code | 06112-1260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467448878 | Kimberly L Beaulieu | Physician Assistant | 675 Tower Ave, Hartford, CT 06112-1264 | 2005-09-21 |
| 1053833475 | Mona Anne Chiurillo | Nurse Practitioner | 675 Tower Ave, Hartford, CT 06112-1273 | 2017-07-07 |
| 1457758179 | Shivanna Subramani Gonzalez | Nurse Practitioner | 675 Tower Ave, Hartford, CT 06112-1273 | 2014-11-24 |
| 1750626032 | Melissa Leigh Costanzo | Marriage & Family Therapist | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2012-11-28 |
| 1477846319 | Susana L Mealha | Social Worker | 675 Tower Ave, Suite 303, Hartford, CT 06112-1273 | 2011-05-25 |
| 1396038691 | Javeeria Manzoor | Psychiatry & Neurology | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2011-05-18 |
| 1912204504 | Elaine F Pratt | Nurse Practitioner | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2011-02-17 |
| 1053613752 | Community Renewal Team | Case Management | 675 Tower Ave, 303, Hartford, CT 06112-1273 | 2010-12-01 |
| 1144522160 | Community Renewal Team Inc. | Case Management | 675 Tower Ave, Hartford, CT 06451 | 2010-11-23 |
| 1154638815 | Mahreen Raza | Psychiatry & Neurology | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2010-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841810355 | Ashwin Mahesh | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, 2nd Floor, Burgdorf Clinic, Hartford, CT 06112 | 2020-04-24 |
| 1336600527 | Waleed Ibrahim | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic, 131 Coventry Street 2nd Floor, Hartford, CT 06112 | 2019-03-29 |
| 1740741941 | Hajra Munawar | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic 131 Coventry Street, Hartford, CT 06112 | 2019-03-29 |
| 1194191973 | Esther Wint | Nurse Practitioner | 490 Blue Ave, Hartford, CT 06112 | 2015-08-17 |
| 1194105700 | Michelle Russi | Physical Therapy Assistant | 490 Blue Hill Ave., Hartford, CT 06112 | 2015-06-09 |
| 1366858359 | Krysten N Marotta | Pharmacist | 1290 Albany Ave, Hartford, CT 06112 | 2014-07-10 |
| 1447403522 | Moon Hee Yoo | Psychiatry & Neurology | 500 Vine St., Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1992958094 | Roxann Marie Ellis-denby | Social Worker | 51 Coventry Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1265590871 | The Connecticut Institute for The Blind | Intermediate Care Facility, Mentally Retarded | 120 Holcomb Street, Hartford, CT 06112 | 2006-12-05 |
| 1164580379 | Intercommunity, Inc. | Clinic/Center | 16 Coventry Street, Hartford, CT 06112 | 2006-12-04 |
| Find all providers in zip 06112 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891159596 | Andrea Leigh Gillis | Family Medicine | Family Medicine Center At Asylum Hill, 99 Woodland St, Hartford, CT 06105 | 2016-04-08 |
| 1366679565 | William C Popik | Family Medicine | 90 Goodwin Cir, Hartford, CT 06105-5205 | 2009-06-15 |
| 1093989519 | Vivian Olsen Simmons | Family Medicine | 169 2nd Avenue, Hartford, AL 36344-1219 | 2008-04-15 |
| 1518130004 | Kamalpreet Dulai | Family Medicine | 110 Lone Oak Lane, Hartford, WI 53027 | 2008-04-07 |
| 1780877381 | Ohio County Hospital Corporation | Family Medicine | 20 Mcmurty Avenue, Hartford, KY 42347 | 2007-08-27 |
| 1912928169 | Collins Medical Associates 2 PC | Family Medicine | 95 Woodland St Fl 1, Hartford, CT 06105-1230 | 2006-07-22 |
| 1942225313 | Richard Thomas Kennedy | Family Medicine | 169 North Second Ave, Hartford, AL 36344 | 2006-07-13 |
| 1417908948 | Suzanne Gehl | Family Medicine | 1023 W State St, Hartford, WI 53027-2726 | 2006-05-12 |
| 1386609543 | Kellie Distefano | Family Medicine | 525 S Center St, Hartford, MI 49057-1362 | 2006-04-19 |
| 1851362180 | Kevin Lamont Collins | Family Medicine | 19 Woodland Street, Suite 42, Hartford, CT 06105 | 2006-01-26 |
| Find all providers in HARTFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.